Student Nurse Helen Farmer uses her recent knowledge and evidence to support advocating a patient’s concern over pain.
This week I encountered a very young patient who reported that she was in significant pain, despite being up to date with several different prescribed analgesics.
On reporting this to the nurse in charge and again later at handover, I was surprised to find that the nurse suggested that the patient’s pain was not as bad as the patient was maintaining. The nurse discussed with me what she considered typical behaviours of people who were in severe pain. I listened and absorbed the information. However, I found this reasoning difficult to accept despite the nurse’s many years of experience.
I drew on my recent lectures on the “concept of total pain” and how other factors can directly impact on pain. I went back to my patient and had a chat with her; I was able to establish some factors which may have increased her pain levels. These other factors included fear of disbelief regarding her pain, being away from home, missing out on her studies, not being prescribed her regular medications for her Irritable Bowel Syndrome (IBS). Armed with my new information which relates to the concept of “total pain”, we made a plan. We discussed mitigation for studies, reassurance that she would go home soon and that her family could visit and with the nurse’s agreement, I asked the doctor if she could prescribe the patient’s usual IBS medication. I think my patient felt a sense of relief following this.
Strangely enough, the following day, my patient’s pain had reduced to a manageable level; she was smiling and even went home.
Whilst I do not take credit for this change in pain, I believe my actions had an impact. I stood by my training, used it as a tool and continued to act as an advocate for my patient. I recall a university lecturer telling us not to turn into the “Pain Police” - referring to not judging pain you cannot feel for yourself. I remember laughing at this phrase. However, I believe my patient benefited from it this week.
Staying strong when others may disagree with you is something I have experienced this week. I was concerned how my different opinion may have affected my relationship with the nurse. I maintained my position and expressed an evidence-based opinion politely, whist acting as an advocate for the patient. A positive outcome all round!
Helen Farmer is a student nurse at University of Worcester, currently on placement on a Women’s Health Unit.